The Black-White Achievement Gap Amongst Struggling Readers: A Case Study of Early Intervention Outcomes in Massachusetts

A number of analyses of large data sets have suggested that the reading achievement gap between African American and White U.S. is negligible or small at school entry, but widens substantially during the school years because African American students show slower rates of growth in elementary and secondary school. Identifying when and why gaps occur, therefore, is a an important research endeavor. In addition, being able to predict which African American children are most likely to fall behind can contribute to efforts to close the achievement gap. This paper analyzes first grade and third grade data on African American and White children in Massachusetts who all were identified in first grade as struggling readers and enrolled in Reading Recovery—an individualized intervention. All the children were low-income and attending urban schools. Using Observation Survey data from first grade, and MCAS Reading data from 3rd grade, we found that the African American and White students made equal average progress while in first grade, but by the end of third grade showed a large gap in MCAS proficiency rates. We discuss the results in terms of school quality, reading development, dialect issues, testing formats, and the need to provide long-term support to vulnerable learners.

What Happens in the Links? Framing Judgment in Context

Scholars of Chaucer’s Canterbury Tales have focused much of their research on the interpretation of individual tales in the collection. The meaning behind these tales is clearly important to the work as a whole, as the Tales discuss grand themes that run throughout human life. The choice of themes and arguments in each pilgrim’s tale can also reflect back on the pilgrim’s own motivations and ideas. However, in searching for some greater meaning for Chaucer’s collection, it is important not to leave out the framework within which the tales exist. The links that join the tales to one another, arguably the portions of the piece that are the most original to Chaucer, do not always receive the same kind of attention that is focused on the most popular tales. In a work that is so complex, with its layered narration and interactions between tale and teller, the tales cannot possibly stand on their own, containing all of the meaning behind the work. The links have the potential to be particularly revealing in terms of how the audience should read the entire story of Chaucer’s Canterbury pilgrimage, because they ground the tales in specific circumstances.

Onthullingen uit de vrouwenkampen in Zuid-Afrika

Emily Hobhouse

The association of food sources of calcium with weight class in adolescent girls

To determine the association of food sources of calcium with weight class in adolescent girls, the major food sources of calcium were determined for 718 sixth grade girls at three different time periods during an 18 month school-based health intervention program using a FFQ. To determine weight class, the BMI of each girl was stratified using CDC age and gender specific criteria at each time period. The percent contribution of the major food sources of calcium to total calcium intake was compared among the different weight classes at each time period, among those girls who had changed weight class at the different time periods and for those girls who did not change weight class at the different time periods. The mean total calcium intake increased by 20% between the first two time periods and by 12% between the first and last time periods with the intervention despite baseline total calcium intake already being greater than the recommended 1300 mg/day. The percent contribution of the major food sources of calcium were highly correlated among the weight classes that were compared throughout the study. Those girls who remained in the normal weight class throughout the study had the most consistent intake of food sources of calcium. Their top four food sources of calcium were different types of milk which provided greater than 50% of their total calcium intake. Despite there being no significant differences in the major food sources of calcium among the different weight classes, these data show a successful intervention for increasing calcium intake among adolescent girls. ^

Depression care for the old-old in a primary care setting

Objective. Although those age 75 and older are the fastest growing age group in the U.S., few studies focus on the course and treatment of depression in this age group. This study examines the differences between the young-old (age 60 to 74) and the old-old (age 75 and older) in regards to their response to a collaborative care model for depression in primary care. We hypothesized that old-old participants would have more severe depression and have a lower rate of treatment response compared to young-old participants. ^ Methods. The sample consisted of 906 participants (n = 606 young-old; n = 300 old-old) who were randomized to receive the intervention with a depression care manager in the IMPACT trial. This study compared young-old and old-old patients on process of care and outcome variables to identify potential differences between the two age groups. Process of care was determined by the type of treatment and level of stepped care received. Clinical outcomes included SCL-20 depression scores, treatment response (defined as a ≥50% decrease in SCL-20 score from baseline) and complete remission (defined as a SCL-20 score <0.5) at 3-, 6-, and 12-months follow-up. ^ Results. The process of care variables did not differ between the two age groups. SCL-20 depression scores did not significantly differ between the two age groups at all follow-up intervals. Treatment response was significantly different between young-old and old-old participants at 6- and 12-months. Complete remission rates were significantly different between the two age-groups at 12-months follow-up. ^ Conclusions. Young-old and old-old patients have a similar clinical response to initial collaborative depression care in a primary care setting, but old-old patients may have lower rates long-term treatment response and complete remission. These findings will help guide future clinical and public health approaches to treat old-old patients with depression. ^

The association between uterus shape and development of chronic conditions in a retrospective corhort of diethylstilbestrol-exposed women in Minnesota and Texas

Diethylstilbestrol (DES) exposed women are well known to be at increased risk of gynecologic cancers and infertility. Infertility may result from DES associated abnormalities in the shape of women's uteri, yet little research has addressed the effect of uterine abnormalities on risk of infertility and reproductive tract infection. Changes in uterine shape may also influence the risk of autoimmune disease and women's subsequent mental health. A sample of consenting women exposed in utero to hormone who were recruited into the DESAD project, underwent hysterosalpingogram (HSG) from 1978 to 1984. These women also completed a comprehensive health questionnaire in 1994 which included women's self-reports of chronic conditions. HSG data were used to categorize uterine shape abnormalities as arcuate shape, hypoplastic, wide lower segment, and constricted. Women were recruited from two of the four DESAD study sites in Houston (Baylor) and Minnesota (Mayo). All women were DES-exposed. Adjusted relative risk estimates were calculated comparing the range of abnormal uterine shaped to women with normal shaped uteri for each of the four outcomes: infertility, reproductive tract infection, autoimmune disease and depressive symptoms. Only the arcuate shape (n=80) was associated with a higher risk of infertility (relative risk [RR]= 1.53, 95% CI = 1.09, 2.15) as well as reproductive tract infection (RR= 1.74, 95% CI = 1.11, 2.73). In conclusion, DES-associated arcuate shaped uteri appeared to be associated with the higher risk of a reproductive tract infection and infertility while no other abnormal uterine shapes were associated with these two outcomes.^

Suspected outbreak of dengue fever in Houston: Clinical characteristics and determination of autochthonous transmission between 2003 and 2005

Houston, Texas maintains the appropriate climate and mosquito populations to support the circulation of dengue viruses. The city is susceptible to the introduction and subsequent local transmission of dengue virus with its proximity to dengue-endemic Mexico and the high degree of international travel routed through its airports. In 2008, a study at the University of Texas School of Public Health identified 58 suspected dengue fever cases that presented at hospitals and clinics in the Houston area. Serum or CSF samples of the 58 samples tested positive or equivocal for the presence of anti-dengue IgM antibodies (Rodriguez, 2008). Here, we present the results of an investigation aimed to describe the clinical characteristics of the 58 suspected dengue fever cases and to determine if local transmission had occurred. Data from medical record abstractions and personal telephone interviews were used to describe clinical characteristics and travel history of the suspected cases. Our analysis classified six probable dengue fever cases based on the case definition from the World Health Organization. Three of the probable cases for which we were able to obtain travel history had not recently traveled to an endemic area prior to onset of symptoms suggesting the illnesses were locally acquired in Houston. Further analysis led us to hypothesize that additional cases of dengue fever are present in our study population. Fifty-one percent of the study population was diagnosed with meningitis and/or encephalitis. Sixty percent of the individuals who received a lumbar puncture had abnormal CSF. Together these findings indicate viral infection with neurological involvement, which has been reported to occur with dengue fever. Among the individuals who received liver enzyme analysis, 54% had evidence of abnormal liver enzyme levels, a clinical sign commonly observed with dengue. Our results indicate that a suspected outbreak of dengue fever with autochthonous transmission occurred in the Houston area between 2003 and 2005. ^

Has the development of a New Urbanist community affected the physical activity levels of residents in surrounding neighborhoods?

Study Aims. The neighborhood environment has been shown to influence physical activity levels, but little is known about how far-reaching these effects are. This study sought to determine whether or not the development of a New Urbanist community in Austin, Texas affected the physical activity levels of residents in surrounding neighborhoods. The results were stratified by demographic characteristics, residential distance from the New Urbanist community, and type of physical activity to determine if any observed changes varied by these factors.^ Methods. Self-report questionnaires were mailed to a random sample of households located within one mile of the New Urbanist development. The questionnaire included questions about physical activity behaviors before and after the community was constructed in 2006. Changes in reported levels of physical activity between the two time points were examined.^ Results. The prevalence and average minutes per week of total physical activity did not change. Significant increases in the frequency and quantity of moderate-intensity leisure-time physical activity were observed. The amount of time spent walking and biking for recreation outside of the neighborhood increased significantly among those living close to Mueller. The weekly time spent in vigorous-intensity activity increased significantly, especially among those living closer to Mueller. There were significant decreases in the prevalence of and time spent walking for transport. The use of Mueller parks and trails was highest among participants living close to Mueller.^ Conclusions. The nearby Mueller development does not appear to have encouraged sedentary members of the surrounding population to become physically active, but might be associated with increased weekly physical activity among those who were already active. The increase in vigorous-intensity physical activity and recreational walking/biking outside of the neighborhood among those subjects living closer to Mueller may be attributed to the use of Mueller parks and trails, which was also considerably higher among this group. People may be substituting the time they spent walking for transport before the Mueller development with moderate-intensity leisure-time physical activity. Future research should seek to identify barriers that may be preventing more nearby residents from using Mueller facilities for physical activity. ^

Targeted immunization to protect infants against pertussis in the United States

Pertussis is an infectious disease caused by the bacteria Bordetella pertussis, and is associated with a serious respiratory infection, a prolonged cough, and can require hospitalization. A vaccine for adolescents and adults has been available since 2005. This paper examines one recommended immunization strategy to prevent pertussis among infants, called “cocooning.” The strategy focuses on creating immunity among adult caregivers so they serve as a protective cocoon to the newborns, who are too young to be vaccinated. This paper looks at relevant studies summarizing implementation of cocooning strategies and addresses the question – Does the research literature support the view of using cocooning as an effective strategy to prevent pertussis in infants? After exclusions, 8 studies remained for synthesis. The evidence shows that cocooning is complex strategy and the evidence is mixed when it comes to ensuring an increase in immunization of caregivers. ^

Provider perceptions of physical activity counseling: A systematic review

Background: Although the health benefits of physical activity are well-established, the evidence regarding the efficacy of physical activity counseling by primary care providers is inconclusive. Healthy People 2020 recommends that physicians provide counseling on physical activity to their patients; however, few providers adhere to these guidelines. The primary objective of this review is to systematically summarize and evaluate primary care providers' perceptions and attitudes about physical activity counseling. ^ Methods: A systematic literature search of relevant articles was conducted between January and May 2011 using four databases: MEDLINE (1948 to the present), PsycInfo (1806 to the present), CINAHL Plus with Full Text (1981 to the present), and the Cochrane Library. Studies were included if 1) the study population consisted of primary care providers and, 2) the study evaluated providers' attitudes and perceptions pertaining to physical activity counseling. Both quantitative and studies were considered. ^ Results: Most primary care providers agree that physical activity counseling is important and that they have a role in promoting physical activity to their patients. Providers are uncertain about the effectiveness of counseling, feel only marginally comfortable providing more than general advice about physical activity, and cite major barriers to counseling such as lack of time, lack of training, and lack of reimbursement for their counseling efforts. The evidence in this review suggests that beyond these barriers, providers are more likely to counsel their patients about physical activity if they are active themselves, or if they feel that their patients' condition, such as cardiovascular disease or obesity, would strongly benefit from a lifestyle change. ^ Conclusion: While major barriers to physical activity counseling, such as lack of time for counseling and lack of counseling knowledge still exist, primary care providers are receptive to the idea of acting as physical activity promoters in their clinical practices. However, the barriers encountered need to be addressed on multiple levels (e.g. individual, organizational), and additional training is needed in order for providers to effectively promote the physical activity of their patients.^

Evidence of hepatitis C transmission in healthcare settings in Karachi, Pakistan

Transmission of Hepatitis C (HCV) in Pakistan is a continuing public health problem. Several cultural and behavioral practices promote HCV transmission through the use of unsafe needles and blood products. This study aimed to determine the prominent risk factors associated with HCV transmission in the Indus Hospital catchment population. A case-control study design was implemented to enroll 300 laboratory confirmed HCV+ participants from consulting clinics at Indus Hospital and 300 laboratory confirmed HCV− participants from both the consulting clinics and the surrounding community. Odds ratios and their 95% were calculated for each risk factor to create a two gender specific multivariable models and a combined multivariable model. Participants who received 12 or more injections in the past year, ever received a blood transfusion, or ever had dental work performed were all independently significant more likely to be HCV+ when compared to those who received 1–4 injections in the past year, never received a blood transfusion, or never had dental work performed. Female participants who received 12 or more injections in the past year, had a blood transfusion while pregnant, or ever had dental work performed were all significantly more likely to be HCV+ while males who received 12 or more injections in the past year were also significantly more likely to be HCV+. Participants who brought their own needles to their injections or infusions along with those who were born in the Sindh province were significantly less likely to be HCV+ when compared to those who did not bring their own needles or born in the Punjab province. ^ Clearly transmission in healthcare settings are implicated for HCV transmission. A population level preventative approach must be taken to educate both the population and healthcare practitioners to prevent further transmission in the Pakistani healthcare system. Participants should also be followed and re-interviewed to ask where they received their various treatments as well as assess their knowledge and attitudes towards injections, infusions, and other unsafe medical procedures.^

Sudden Infant Death disparities: A systematic review on health education and policy recommendations for decreasing Sudden Infant Death in the African-American community

Objective: To perform a systematic review of the literature on SIDS and SUID deaths concentrated in the African-American community, describe health education and policy recommendations and recommend a new approach that may aid in decreasing the disparity of infant mortality in the African-American community. ^ Methods: The PubMed database was systematically searched to identify relevant articles for final review and analysis. Using the CASP 2006 system to critique literature, twelve articles were found that met inclusion and exclusion criteria. ^ Results: Evidence in the literature confirmed there was a current disparity among African Americans' infant mortality rates in comparison to other US ethnic groups. The underlying reasons for these disparities included the following maternal and infant characteristics: mothers younger than eighteen, having more than one live infant, having a high school education or less, never been married, and have infants born preterm or with low birth weight. Maternal smoking, substance abuse, and breastfeeding did not have a significant impact on infant sleep environments among African Americans. ^ Conclusion: Tailored health education programs at the community level, better access to pre-pregnancy and prenatal care, and increased maternal perception of risk that is relevant to the infants sleeping environment are all possible solutions that may decrease African American infant mortality rates.^